Surgery to treat atrial fibrillation

Some people with an irregular heartbeat may have a small device fitted inside their heart to help manage their condition. There are a few different types:

• Pacemakers send small electrical signals to keep the heart beating at a steady, regular rhythm.
• Implantable cardioverter defibrillators (ICDs) work in a similar way but can also deliver a stronger electrical pulse to reset the heart’s rhythm if it becomes dangerously irregular.
• Left atrial appendage closure devices (such as the Watchman device) are a non-electrical option for people who cannot take certain blood-thinning medications. They work by blocking off a small pouch in the heart where blood clots commonly form, helping to reduce the risk of a further stroke¹.

Carotid endarterectomy and stenting

The carotid arteries in your neck, are the main blood vessels that supply blood to the face and brain. Fatty deposits (or plaque) can build up in them causing stenosis or narrowing of the artery. Small bits of the deposits can break off and travel into the brain blocking smaller arteries and causing stroke or transient ischaemic attacks.

An ultrasound scan of the carotid artery can detect stenosis and should be a routine investigation after someone has a transient ischaemic attack (TIA) as these partial blockages of the carotid artery greatly increase the risk of a further TIA or stroke. A surgical procedure called carotid endarterectomy should be used as soon as possible after stenosis has been diagnosed to scrape out the deposits, or a stent can be inserted into the carotid artery to maintain adequate blood flow.

Surgery to treat obesity

When other measures have failed to help people with obesity to reduce their weight they may be considered for bariatric surgery if they meet certain criteria: either a BMI (body mass index) of 35 or greater with obesity-related health conditions or a BMI of 40 or greater without significant obesity-related health conditions. There are a range of procedures including:

• gastric bypass, where a large part of the stomach is sealed off from the digestive process
• gastrectomy, where a large proportion of the stomach is removed
• or a duodenal switch, which alters the hormones responsible for feelings of hunger and feeling full.